Evaluation method of training simulation on biological models for cardiovascular surgery residents

Abstract

Objectives: The goal of this study was to describe and evaluate our simulation training program on biological models for the cardiovascular surgery residency program at our institution.Material and Methods: Since 2016, with the purpose to develop better practical performance and evaluate the improvement of resident's surgical skills, a simulation training program was implemented, composed of some elemental procedures in cardiovascular surgery. It was established with one wet lab session weekly lasting 2 h, coached by two expert cardiovascular surgeons. Bovine and porcine hearts were used as biological models. At the end of the hands-on program, an objective assessment consisting of two practical modules was applied and performance was rated by way of a 5-point scale. In addition, to provide a subjective assessment, each resident filled out a questionnaire consisting of three items reviewing the overall quality of the workshops on a 10-point scale.Results: The objective evaluation applied at the end of the training program consisted of valve replacement and coronary artery bypass grafting (CABG) modules.The mean performance rating scores for the valve replacement module ranged from 4.2 to 4.79, and CABG, from 4.33 to 4.87. Regarding subjective assessment, all items evaluated, such as expert's didactics, simulation performance, and biological simulator fidelity, received high grades (above 9 on a 10-point scale). Conclusions:Simulator training on biological models for cardiac surgery medical residents is a simple and effective learning method of surgical skills.

Teaching heart valve surgery techniques using simulators: a systematic review

“…Brandão and colleagues 26 described the results of a 5-week high-fidelity training program on AVR, MVR and coronary artery bypass surgery for second- and third-year cardiovascular surgery residents. After the simulation program, the residents received mean performance ratings on a 5-point Likert score of 4.79, 4.72, 4.47, 4.34 and 4.20 for anatomy knowledge, valve excision, stitches in the annulus, prosthesis implantation and time, respectively.…”

“…Significant improvement in surgical trainees’ time to completion of tasks, number of mistakes, skills scores and theoretical knowledge after participation in SBT has been reported. 5 , 11 , 12 , 26 – 28 , 30 , 35 – 37 The use of SBT in training for heart valve surgery is relatively limited compared to other surgical fields, such as coronary revascularization. 38 As such, further investigation into the use of SBT for teaching valve repair and replacement techniques is warranted to identify the optimal use of SBT for training surgical residents.…”

“…After the procedure, an endoscopic view can be used to assess the quality of the repair, as an intra-aortic balloon pump allows for realistic opening and closing of the valves. Brandão and colleagues 26 constructed a high-fidelity simulation model for AVR using bovine hearts situated in a synthetic box (Gbs – Simuladores Medicos) to reproduce anatomic position and surgical perspective. Donated authentic valve prostheses are used in the simulation sessions.…”

“…High-fidelity MVR simulations described by Brandão and colleagues 26 and Sharma and colleagues 27 are equivalent to their AVR simulations described in the previous section, with the exception that Brandão and colleagues 26 used porcine hearts as opposed to bovine hearts.…”

HANDS-ON: Training Simulation in Surgery

“…These In general, most of the residents reported that the program could provide a realistic experience and be valuable in teaching surgical skills. 5 We observed that biological models with porcine or bovine hearts provided a high degree of realism. In the case of cardiac surgery, where surgical failure may result in patient morbidity and mortality, such a realistic simulation could reproduce better surgical results, which is essential before clinical application.…”